Clomiphene citrate
U.S. Brand Names: Clomid®; Serophene®; Milophene®
Use: Stimulates follicle-stimulating hormones to trigger ovulation. Good for women who ovulate irregularly or not at all, women with polycystic ovarian syndrome and women with luteal phase deficiency. Usually given before trying assisted reproductive technology such as in vitro fertilization.
Adverse Reactions: Mood swings, dry cervical mucus, mild ovarian enlargement (swelling), stomach pain, breast tenderness, insomnia, nausea, vomiting, blurred vision, headaches, fatigue, irritability, depression, weight gain, ovarian cysts. Side effects: hot flashes, breast tenderness, mood swings, visual problems, thick cervical mucus, luteal phase deficiency, use for more than a year may increase the risk of ovarian cancer.
Greater than 1% experience:
Ovarian enlargement, vasomotor flushes, abdominal-pelvic discomfort/distention/bloating, nausea and vomiting, breast discomfort, visual symptoms (blurred vision, lights, floaters, waves, unspecified visual complaints, photophobia, diplopia, scotomata, phosphenes, headache, abnormal uterine bleeding, intermenstrual spotting, menorrhagia.
Less than 1% experience:
Appetite increase, constipation, dermatitis or rash, depression, diarrhea, dizziness, fatigue, hair loss/dry hair, increased urinary frequency/volume, insomnia, light-headedness, nervous tension, vaginal dryness, vertigo, weight gain/loss
Other symptoms include the following:
- Dermatologic: Acne, allergic reaction, erhthema, erythema multiforme, erythema nodosum, hypertrichosis, pruritus
- Central nervous system: Migraine headache, paresthesia, seizure, stroke, syncope
- Psychiatric: Anxiety irritability, mood changes, psychosis
- Visual: Abnormal accommodation, cataract, eye pain, macular edema, optic neuritis, photopsia, posterior vitreous vitreous detachment, retinal hemorrhage, retinal thrombosis, retinal vascular spasm, temporary loss of vision
- Cardiovascular: Arrhythmia, chest pain, edema, hypertension, palpitation, phlebitis, pulmonary embolism, shortness of breath, tachycardia, thrombophlebitis
- Musculoskeletal: Arthralgia, back pain, myalgia
- Hepatic: Transaminases increased, hepatitis
- Genitourinary: Endometriosis, ovarian cyst (ovarian enlargement or cysts could, as such, be complicated by adnexal torsion), ovarian hemorrhage, tubal pregnancy, uterine hemorrhage
- Body as a whole: Fever, tinnitus, weakness
- Other: Leukocytosis, thyroid disease
- Fetal/Neonatal Abnormalities: Delayed development, abnormal bone development including skeletal malformations of the skull, face, nasal passages, jaw, hand, limb, foot, and joints; tissue malformations including imperforate anus, tracheoesophageal fistula, diaphragmatic hernia, renal agenesis and dysgenesis, and malformations of the eye and lens (cataract), ear, lunch, heart, and genitalia, as well as dwarfism, deafness, mental retardation, chromosomal disorders, and neural T.B. defects
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Bromocriptine Mesylate
U.S. Brand Names: Parlodel®
Use: Blocks the release of prolactin and is used to treat menstrual and fertility problems. This drug is most commonly used to treat women with ovulation problems caused by pituitary adenoma (a benign tumor).
Warnings/Precautions: Consult with a health care professional before using this drug if you suffer from heart disease, liver disease, high or low blood pressure, mental disorders, retroperitoneal fibrosis, seizures, have had an allergic reaction to bromocriptine or its components, are pregnant or are trying to get pregnant, or are breast-feeding.
Contraindications: Do not use this drug with alcohol, dihydroergotamine, erythromycin, female hormones (including contraceptive or birth control pills), levodopa, methyserdise, water pills, or medicines for high blood pressure, mental depression, mental problems and psychotic disturbances.
Adverse Reactions: Common side effects include nausea, nasal stuffiness, dizziness, low blood pressure and headaches, weakness on standing, nausea, nasal congestion, confusion or hallucinations, persistent, watery nasal discharge, severe weakness or tiredness, diarrhea or constipation, drowsiness, dry mouth, loss of appetite, runny nose, and stomach pain. Less common side effects include blurred vision, difficulty breathing, fainting spells, dizziness or lightheadedness, irregular heartbeat, chest pain or palpitations, seizures, and vomiting.
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GnRH Analogs
U.S. Brand Names: Lupron®; Synargel®; Nafarelin®; Supprelin®; Zoladex®
Use: This drug prevents the premature release of the egg from the ovaries and turns off the pituitary gland. This drug is commonly used in women whose periods are absent due to the improper function of the hypothalmus, to prevent the premature release of eggs for assisted reproductive technologies, or to induce a menopause-like state to suppress endometriosis or fibroids.
Adverse Reactions: Common side effects include infection of the indwelling line, headaches, hot flashes, and bone loss. This drug is safe for less than 6-9 months and can be used safely for longer periods of time if estrogen is supplemented.
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Human Chorionic Gonadotropin
U.S. Brand Names: Profasi®; Pregnyl®
Use: This drug is used to trigger ovulation and is most commonly used in conjunction with hMG, FSH or clomiphene to force the release of eggs.
Adverse Reactions: Side effects include cramping and hyperstimulation. The risk of ovarian cancer from using this drug is unclear.
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Human Menopausal Gonadotropin (Monotropins)
U.S. Brand Names: Humegon®; Pergonal®; Repronex®
Use: This drug is used in men to help stimulate the development of sperm. In women, this drug stimulates the development of eggs within the ovaries. These drugs are usually used in combination with other fertility drugs and are also used for in vitro fertilization programs. These drugs are most commonly used in women who have problems of the hypothalmus, unexplained infertility, or endometriosis.
Warnings/Precautions: Consult a doctor before using this drug if you have a benign pituitary tumor, cyst on the ovary, ovarian failure, testicular failure, thyroid disease, vaginal or unusual bleeding, an allergic reaction to menotropins or their components, are currently pregnant, or are breast feeding. As with most fertility drugs there is a chance of multiple pregnancies. With this particular drug there is a 25-50% change that multiple pregnancies will occur.
Adverse Reactions: Common side effects include difficulty breathing or shortness of breath, fever, chills or joint or muscle aches, itching, skin rash or hives, swelling of the areas of the face, mouth or throat, chest pain, indigestion, nausea, vomiting, passing small amounts of urine, stomach area or pelvic pain or bloating, swelling of any area of the body, rapid weight gain, breast enlargement in men, breast tenderness, dizziness, headache, mild pain, redness, inflammation at the injection site, tiredness, mood swings, and ovarian hyperstimulation.
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Human FSH Urofollitropin
U.S. Brand Names: Metrodin®; Fertinex®
Use: These drugs are used to directly stimulate the ovaries and are most commonly used in women with anovulation, unexplained infertility, endometriosis, and for ovarian stimulation for assisted reproductive technologies.
Adverse Reactions: There is a 25-50% chance that multiple pregnancies will result from using this drug. Common side effects include mood swings and ovarian hyperstimulation.
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Recombinant FSH (Follitropins)
U.S. Brand Names: Follistim®; Puregon®; Gonal-F®
Adverse Reactions:
More than 10% experience: Headache, ovarian cyst, nausea, and upper respiratory tract infection.
At least 2% experience the following side effects:
- Reproductive, Female: Intermenstrual bleeding, breast pain, ovarian hyperstimulation, dysmenorrhea, ovarian disorder, cervix lesion, menstrual disorder, leukorrhea, vaginal hemorrhage
- Gastrointestinal: Abdominal pain, nausea, flatulence, diarrhea, vomiting, dyspepsia
- Central and Peripheral Nervous System: Headache, dizziness
- Neoplasm: Ovarian Cyst
- Body as a whole: Pain, back pain, influenza-like symptoms, fever, abdominal pain, pelvic pain
- Respiratory System: Upper Respiratory Tract Infection, Sinusitis, Pharyngitis, Coughing, rhinitis
- Skin and Appendages: Acne
- Psychiatric: Emotional liability
- Urinary system: Urinary tract infection
- Resistance Mechanism: Moniliasis Genital
- Application Site: Injection site pain
- Metabolic and Nutritional: Weight Increase
1% to 2% experience: D&C following delivery or abortion, dysmenorrhea, vaginal hemorrhage, diarrhea, tooth disorder, vomiting, dizziness, paraesthesia, abdomen enlarged, chest pain, fatigue, dyspnea, anorexia, anxiety, somnolence, injection site inflammation, injection site reaction, pruritus, pruritus genital, myalgia, thirst, and palpitation
Rare: spontaneous abortion, ectopic pregnancy, premature labor, postpartum fever, congenital abnormalities, and congenital cardiac malformations in infant.
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Coverage of Drug-Induced Nutrient Depletion, Drug Brand Names, Contraindications, Warnings/Precautions, Adverse Reactions, Overdose/Toxicology, etc.